Dr. Michael Kaplitt has not slowed down since pioneering the use of high-intensity focused ultrasound (FUS) for the treatment of essential tremor. Since the procedure was approved by the FDA in 2016, Dr. Kaplitt has performed it hundreds of times, restoring function to patients’ dominant hand. This summer, in a paper published in the Journal of the American Medical Association (JAMA Neurology), he and 14 co-authors announced more good news. The results of their clinical trial of MR-guided FUS in patients previously treated for essential tremor show second-side treatment to be safe and effective. In an accompanying editorial, the 73% improvement in functional disability scores was noted as being remarkable, with the authors commenting that the best results could be expected when the procedure is conducted by highly experienced providers.
“We knew there was strong demand for the procedure on the dominant side, since the improvement in quality of life is so dramatic,” said Dr. Kaplitt, who was the lead author of the study. “Patients who had not been able to hold a pen or a glass, sometimes for decades, could walk out of the hospital after just a few hours with the use of their dominant hand restored. But many patients have tremor in both hands and some have voice or head tremors, and these are usually not improved by a single-side treatment. In a world where holding a cellphone with one hand and touching the screen with the other is part of everyday life, the need for tremor control in both hands is essential.”
Dr. Kaplitt helped to design and lead the clinical trial testing the safety and efficacy of the procedure on the second side, which took place at seven academic medical centers in the United States. The resulting paper, “Safety and Efficacy of Staged, Bilateral Focused Ultrasound Thalamotomy in Essential Tremor,” reports on 51 patients who participated in the trial between July 2020 and October 2021. The results reported in this study were previously presented to the FDA and led to an additional approval of this procedure on the second side over one year ago, so this treatment is now available to any tremor patient.
“The quality-of-life improvement in patients having the second-side treatment is extremely gratifying,” said Dr. Kaplitt. “While every procedure that changes the brain can have some risks, the low frequency of even relatively mild adverse events in a noninvasive procedure that can be done in just a few hours, with such dramatic and immediate results, and which allows patients to return home the same day, is quite remarkable.”
Co-authors include many distinguished researchers and clinicians who have been leading the way on focused ultrasound applications. See the abstract here.
More about Dr. Kaplitt
At top: Alexandra Lebenthal took this remarkably unremarkable selfie a week after her FUS procedure... using her newly treated non-dominant hand. Read her story here.